Dementia

Dementia is an umbrella term used to describe a decline in cognitive function that impairs a person's ability to function in daily life. Some cognitive decline is normal with aging. However, it is quite subtle, like misplacing keys. But the cognitive decline associated with dementia is severe. For instance, a person with dementia may forget the names of their loved ones. The World Health Organization (WHO) estimates that more than 55 million people worldwide have dementia.^[1]

People with dementia may experience the following symptoms:

• Inability to perform activities of daily living, such as bathing, eating, or getting dressed
• Forgetting the names of friends and family
• Getting lost in familiar places
• Difficulty walking
• Mood swings
• Depression

People with dementia may become disoriented and wander away from home as their condition worsens. In severe cases, they may require complete assistance in caring for themselves.

There is no definitive test for dementia. To make a diagnosis, a healthcare provider must first rule out reversible causes of dementia based on assessing a person’s medical history and overall health status. Physical examinations, cognitive tests, blood tests, and brain imaging may all be used to make the diagnosis.

For most types of dementia, medications are prescribed to control symptoms. For example, acetylcholinesterase inhibitors and N-Methyl-D-Aspartic Acid (NMDA) antagonists treat cognitive symptoms in people with Alzheimer's Disease, but they do not slow the progression of the disease. Statins, antithrombotics, anticoagulants, and blood pressure medications may be used to reduce the risk of cardiovascular events (e.g., strokes or heart attacks) in people with vascular dementia (a form of dementia caused by inadequate blood flow to the brain). Furthermore, antidepressants are also commonly prescribed to treat depression associated with dementia.^[2][3]

Numerous supplements, including ginkgo biloba, B-vitamins (namely folic acid, vitamin B12, and vitamin B1), vitamin D, vitamin E, oxiracetam, piracetam, and alpha-GPC, to name a few, have all been studied for dementia. However, there is mixed evidence regarding their efficacy in enhancing cognitive function in people with dementia.

Observational studies have found that diets such as the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets are associated with a lower risk of cognitive decline and Alzheimer’s Disease. However, there isn’t enough evidence to say whether this benefit applies to all types of dementia.^[4] Since most research has been observational, more robust evidence is needed before any dietary recommendations for dementia can be made.

Mentally stimulating activities such as reading or playing board games can help people with dementia maintain daily functioning and cognition. Reminiscence therapy, a form of psychotherapy that involves recalling old memories and life events, can help improve psychological well-being for people experiencing memory problems related to dementia. Furthermore, aerobic and resistance training can help improve cognitive function in people with Alzheimer’s Disease.^[2]

There is no one cause of dementia. Many different conditions can cause dementia. The most common causes of dementia are neurodegenerative diseases, such as^[5]:

• Alzheimer’s Disease
• Vascular dementia
• Dementia with Lewy bodies
• Parkinson’s disease
• Frontotemporal lobar degeneration

Although rare, other conditions may also cause dementia or similar symptoms. Some examples include^[6][5]:

• Vitamin B12 deficiency
• Hypothyroidism
• Creutzfeldt-Jakob disease
• Huntington’s disease
• Pellagra